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Infectious Disorders - Drug Targets

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ISSN (Print): 1871-5265
ISSN (Online): 2212-3989

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Research Article

Discharge of Confirmed COVID-19 Patients Based on WHO or Regional Criteria? A Cohort Study

Author(s): Seyed-Hasan Adeli, Mahmoud Parham, Akram Asghari, Mohammad Bagherzade, Rasoul Shajari, Reihane Tabarraii, Masoumeh Shakeri, Amir Jabbari, Saeede Jafari, Sajjad Ahmadpour*, Mohammad Amin Habibi, Javad Khodadai, Hamed Shafiee, Narges Eskandari, Davoud Olad Dameshghi, Maryam Masoumi, Seyed Yaser Foroghi Ghomi, Ali Ebrazeh and Jamshid Vafaeimanesh*

Volume 23, Issue 1, 2023

Published on: 27 August, 2022

Article ID: e150822207493 Pages: 8

DOI: 10.2174/1871526522666220815151958

Price: $65

Abstract

Background: Increasing the number of COVID-19 patients raises concerns about the capacity of the health care system. This issue emphasizes reducing the admission rate and expediting patient discharge. Objective: This study aimed to develop a discharge protocol for COVID-19 patients based on the existing capacity of the healthcare system and to assess its post-discharge outcomes.

Methods: This is a multicenter cohort study. All COVID-19 patients referred to selected medical centers in Qom, Iran, from Feb. 19 to Apr. 19, 2020, were target populations. Eligible patients were classified into a) the criterion group and b) the non-criterion group. Patients were followed up daily for 14 days after discharge by phone, and the required data was gathered and recorded in follow-up form. Univariate (chi-square and t-tests) and multivariate multiple (multivariate probit regression) analysis were used.

Results: A total of 2775 patients were included in the study (1440 people in the criterion group and 1335 in the non-criterion group). Based on multivariate probit regression, death was statistically associated with discharge outside our criteria (p<0.001), rising age (p<0.001), and being male (p=0.019), and readmission were associated with discharge outside our criteria (p<0.001), rising age (p=0.009), and having the history of underlying diseases (p=0.003). Furthermore, remission had statistically significant associations with discharge based on our criteria (p<0.001), decreasing age (p=0.001), and lack of a history of underlying diseases (p<0.001).

Conclusion: Mortality and readmission were significantly lower according to our discharge criteria. Our designed criteria apply to less developed and developing countries due to the limited capacity and resources available in the health care system.

Keywords: COVID-19, WHO, criteria, discharge, readmission, healthcare, RT-PCR

Graphical Abstract

[1]
Phelan AL, Katz R, Gostin LO. The novel coronavirus originating in Wuhan, China: Challenges for global health governance. JAMA 2020; 323(8): 709-10.
[http://dx.doi.org/10.1001/jama.2020.1097] [PMID: 31999307]
[2]
World Health Organization. WHO Director-General/Speeches/Detail/WHO Director-General's opening remarks at the media briefing on COVID-19 - 11 March 2020. 2020. Available from: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarksat-the-media-briefing-on-covid-19-11-march-2020
[3]
World Health Organization. Home/Emergencies/Diseases/Coronavirus disease (COVID-19)/Situation reports/situation report-200. Available from: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200807-covid-19-sitrep-200.pdf?sfvrsn=2799bc0f_2
[4]
Mounesan L, Eybpoosh S, Haghdoost A, Moradi G, Mostafavi E. Is reporting many cases of COVID-19 in Iran due to strength or weakness of Iran’s health system? Iran J Microbiol 2020; 12(2): 73-6.
[http://dx.doi.org/10.18502/ijm.v12i2.2607] [PMID: 32494340]
[5]
Li R, Rivers C, Tan Q, Murray MB, Toner E, Lipsitch M. The demand for inpatient and ICU beds for COVID-19 in the US: Lessons from Chinese cities. MedRxiv 2020.
[http://dx.doi.org/10.1101/2020.03.09.20033241]
[6]
Chopra V, Toner E, Waldhorn R, Washer L. How should US hospitals prepare for Coronavirus disease 2019 (COVID-19)? Ann Intern Med 172(9): 621-2.
[7]
Zhang T, McFarlane K, Vallon J, et al. A model to estimate bed demand for COVID-19 related hospitalization. MedRxiv 2020.
[http://dx.doi.org/10.1101/2020.03.24.20042762]
[8]
Jin YH, Cai L, Cheng ZS, et al. A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Mil Med Res 2020; 7(1): 4.
[http://dx.doi.org/10.1186/s40779-020-0233-6] [PMID: 32029004]
[9]
Centers for Disease Control and Prevention (CDC). Healthcare Workers. Discontinuation of Transmission-Based Precautions and Disposition of Patients with COVID-19 in Healthcare Settings (Interim Guidance). 2020. Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/disposition-hospitalized-patients.html
[10]
Wu J, Liu J, Zhao X, et al. Clinical characteristics of imported cases of COVID-19 in Jiangsu province: A multicenter descriptive study. Clin Infect Dis 2020; 71: 706-12.
[PMID: 32109279]
[11]
Xing Y, Mo P, Xiao Y, Zhao O, Zhang Y, Wang F. Post-discharge surveillance and positive virus detection in two medical staff recovered from coronavirus disease 2019 (COVID-19), China, January to February 2020. Euro Surveill 2020; 25(10): 2000191.
[http://dx.doi.org/10.2807/1560-7917.ES.2020.25.10.2000191] [PMID: 32183934]
[12]
Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet 2020; 395(10229): 1054-62.
[http://dx.doi.org/10.1016/S0140-6736(20)30566-3] [PMID: 32171076]
[13]
Deng X, Yang J, Wang W, et al. Case fatality risk of novel Coronavirus diseases 2019 in China. MedRxiv 2020.
[http://dx.doi.org/10.1101/2020.03.04.20031005]
[14]
Ahmadi M, Sharifi A, Dorosti S, Jafarzadeh Ghoushchi S, Ghanbari N. Investigation of effective climatology parameters on COVID-19 outbreak in Iran. Sci Total Environ 2020; 729: 138705.
[http://dx.doi.org/10.1016/j.scitotenv.2020.138705] [PMID: 32361432]
[15]
Allred SR, McQuade ST, Merrill NJ, et al. Regional health system shortfalls with a novel COVID-19 model. Rutgers University 2020.
[16]
Bi Q, Wu Y, Mei S, et al. Epidemiology and transmission of COVID-19 in 391 cases and 1286 of their close contacts in Shenzhen, China: A retrospective cohort study. Lancet Infect Dis 2020; 20(8): 911-9.
[http://dx.doi.org/10.1016/S1473-3099(20)30287-5] [PMID: 32353347]
[17]
Lan L, Xu D, Ye G, et al. Positive RT-PCR test results in patients recovered from COVID-19. JAMA 2020; 323(15): 1502-3.
[http://dx.doi.org/10.1001/jama.2020.2783] [PMID: 32105304]
[18]
Chung M, Bernheim A, Mei X, et al. CT imaging features of 2019 novel Coronavirus (2019-nCoV). Radiology 2020; 295(1): 202-7.
[http://dx.doi.org/10.1148/radiol.2020200230] [PMID: 32017661]
[19]
Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: Summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA 2020; 323(13): 1239-42.
[http://dx.doi.org/10.1001/jama.2020.2648] [PMID: 32091533]
[20]
European Centre for Disease Prevention and Control. Publications & data, Novel coronavirus (SARS-CoV-2) - Discharge criteria for confirmed COVID-19 cases. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/COVID-19-Discharge-criteria.pdf
[21]
Flowchart for diagnosis and treatment of COVID 19 in outpatient and admission services, Ministry of Health & Medical Education. In: 2020.
[22]
Luo M, Jiang B, Xu HJ, et al. Analysis of influencing factors of death in patients with COVID-19. Chin Trad Herbal Drugs 2020; 6: 1450-4.
[23]
Ai T, Yang Z, Hou H, et al. Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: A report of 1014 cases. Radiology 2020; 296(2): E32-40.
[http://dx.doi.org/10.1148/radiol.2020200642] [PMID: 32101510]

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